A concussion can be a serious injury, but it is not a life sentence by any means. You CAN get better when you pursue the right approach to treatment with a provider who understands the injury.
What is a concussion?
A concussion is a mild traumatic brain injury caused by a blow or sudden jolt to the head or body. It is important to remember that it is a brain injury, and it must be treated carefully.
When a concussion occurs, the chemicals in the brain are impacted, leading to an ‘energy crisis’. when the brain isn’t getting enough energy, it attempts to compensate by “pulling” energy from other places. The location of these places often dictates what symptoms you may have.
Initial markers can range from brief confusion to loss of consciousness though it is important to recognize that you can still get a concussion even if you don’t get “knocked out”.
Another important falsehood about concussion is that it shows up on a CT scan. People are often surprised that they do not receive a CT scan when they go to their local emergency department with a possible concussion. Concussions cause such microscopic changes in the brain that most concussions do not show up on CT scan results. However, there are many other ways we can diagnose and then treat the injury.
Diagnosing a Concussion
When you bring yourself or your child to the emergency room/doctor’s office, the doctor will ask about the injury and any symptoms that are occurring. This will help us determine not only whether or not a concussion occurred, but also where the energy breakdown is happening.
Once we have that information, we can develop an individualized treatment plan to help you or your child get better. Symptoms can be different for every person, but may include:
- Low energy
- Feeling sick/vomiting
- Blurry or double vision
- Sensitive to light or noise
- Feeling foggy
- Easily confused
- Trouble recalling new information
- Short attention span
- Slower thinking than usual
- Easily frustrated
- Not feeling rested
- Difficulty falling asleep
- Difficulty staying asleep
- Waking up early
- Sleeping too much
There is no ‘one-size fits all’ approach for treating concussion. In fact, because every person and every injury is different, no two concussions are the same. We now know that your child’s brain does need additional rest after a concussion – but only for a few days. In addition, sitting in a dark room without any outside stimulation is no longer a recommendation, and can actually cause more harm than good.
Instead, by a few days post-injury, your child – and any adult for that matter — needs to be exposed to certain activities (e.g. taking a walk, computer work) in moderation, while taking breaks as needed. It’s best to get back to your usual activities as soon as possible (as long as it does not put you at risk for another injury!). Experiencing some concussion symptoms to a mild degree will not do further damage to the brain, but actually helps to “rehab” the brain – much like physical therapy for a knee injury.
There are a plethora of recommendations for concussion recovery. What we, as neuropsychologists, recommend depends upon the child’s ongoing symptoms and how their current condition compares to their baseline functioning (in terms of academic functioning, or even a cognitive testing baseline if the child has one).
The goal is to get you or your child back to your normal activities as quickly as possible in a healthy way. After an injury, it is extremely important to maintain a regulated schedule, in terms of bedtime and wake up time, appetite, and hydration. Our goal is not to keep you out one second longer than you need to be out, but we won’t send you back one second later than it is safe to do so.
Kicking the Tires vs. Checking Under the Hood
Many parents consult their pediatrician or a neurologist to help ensure their child is making a successful recovery. Others go straight to a neuropsychologist for the same reasons. Both paths are wise.
Simply put, the difference between consulting a neurologist versus a neuropsychologist is the difference between walking around a car and checking the engine to determine what is wrong with it.
Neurologists most certainly can effectively treat children and adults for concussion; so can neuropsychologists. Neuropsychologists and neurologists are both valuable members of the treatment team. Neurologists are also trained to help with return-to-play decisions, while a neuropsychologist will help with return-to-school or return-to-work planning.
While neurologists may administer neurocognitive screenings (to test you or your child’s thinking skills), a neurologist may refer a patient to a neuropsychologist when conventional concussion testing isn’t conclusive, and different, more in-depth testing is required.
At WakeMed, I work closely with local pediatricians/primary care doctors, neurologists, and trauma team to ensure both adult and pediatric patients who suffer concussions make a complete recovery.
Contact WakeMed Neuropsychology Today
After you receive a referral from your health care provider, we welcome you to schedule an appointment with us. Fax physician referral forms to 919-350-4409. If you have a referral in hand, you can give us a call at 919-350-6782 to schedule an appointment for a neuropsych concussion evaluation or a physical therapy evaluation.
About Paul Cohen, PhD
Paul Cohen, PhD, a WakeMed neuropsychologist, completed a 2-year fellowship with the creators of ImPACT concussion testing at the University of Pittsburgh Medical Center where he treated over 4,000 individuals who suffered a concussion. He specializes in helping pediatric and adult patients who have suffered concussions make complete recoveries, and welcomes patients with a physician referral. Dr. Cohen can be reached at 919-350-7878.